Tuesday, 31 December 2013

"Get a room". That's what the head of the Shenyang health department Yan Shi did when he wanted to have closer relations with Dr Li Chenyang, the head of the Shenyang Women and Children's Hospital. And now their lunchtime meetup at a local hotel has cost both of them their jobs. The couple were found to have spent three hours together in a hotel room from 10am to 1pm on 27 November. After viewing evidence from room cards and close circuit TV, the city's Party Discipline Inspection Committee has told Mr Yan to hand in his resignation, while Dr Li has been suspended from her post at the hospital.Source: Beijing Daily

by Michael WoodheadA 72-year-old female doctor at Yuanyamei Hospital in Changping district of Beijing is recovering from concussion after being struck on the head in an attack by family members of an infant girl who had been taken to hospital for treatment.
The incident, which occurred on 25 December, was said to have resulted from an argument between a Dr Li and family members after they were told to take their daughter to a clinic where they had already been turned away from after waiting several hours. They claimed the female doctor had insulted and abused the child, accusations that the doctor denies.
After the incident both parties were taken to the police station where mediation is underway.
According to hospital board president Mr Liu, the female doctor know as Li was a senior clinician and had worked at the hospital for more than a year. On the 24th December a 30 year old female brought a 20-month old daughter to the gynaecology department of the hospital for treatment. After waiting there she was told to take the child to the paediatrics department. When the infant was seen by Dr Li and she heard of the infant's condition she suggested the girl be taken to the gynecology department for treatment, and the treatment fee be refunded.
On the 25th the mother returned to the hospital to lodge a formal complaint to the hospital manager, alleging that Dr Li had assaulted and abused their daughter, and she demanded an apology. The manager suggested that the two parties meet to discuss the situation. At that time, Dr Li was in the middle of a clinic and requested that the mother wait outside for her to finish. The mother suddenly burst ito the consulting room and smacked Dr Li on the side of her head, causing concussion. During the attack she said "I will teach you a lesson."
Dr Li was left concussed and diorientated by the assault, and the mother took advantage of the confusion to flee. However, she was apprehended by security staff outside the hospital and brought back.
When Dr Li recovered, both parties were taken to the police station for questioning. A hospital insider said Dr Li had a reputation for being short tempered and sometimes impolite in her speech. However, Dr Li rejected the accusations that she had humiliated the child or argued with the mother and said she was baffled by the unexpected attack on her. She was suffering concussion and los of hearing and blurred eyesight on her left side where she had been struck. The mother and family of the child had offered 2000 RMB in compensation, but Dr Li and her family were now demanding 20,000 RMB in compensation for her injuries.
The original report by Zhang Guijia is published in the Legal Evening News.

Beijing resident, Dong Suxia, 63, has hypertension and coronary disease.
Instead of enduring long waits at various hospitals, Dong goes to a
community health service center to visit a doctor she signed up with a
year ago.
"The doctor is patient and gives me detailed advice on a healthy
lifestyle. She even calls me to see if I take the medicine correctly.
You don't see this in big hospitals," said Dong.
Dong is benefiting from a family doctor plan rolled out in the city in 2011.
According to the plan, community health service centers should set up
teams consisting of a general practitioner, a nurse and a healthcare
assistant, and sign contracts with patients suffering from chronic
diseases in the neighborhood.
The goal is to channel chronic patients away from overburdened large hospitals and better monitor their condition.
Desheng community health service center in Xicheng district, which
Dong visits, is one of the first grassroots healthcare providers to sign
up patients and has taken a lead in chronic disease management.

by Zhang Yiqian
Eight-year-old Han Shuo looks no different from any other young child. She is quiet, loves reading, doing origami and watching singing competitions on TV.
However, she never takes part in sports at school, has to be extremely careful when climbing stairs, and when she has nosebleeds, it takes more than three hours to stop.
When she stands, even her ankle-length cotton dress can't hide the fact that her belly has swollen up like a pregnant woman's: her spleen is almost 40 times the normal size.
"She had wanted to become a doctor when she grows up, but the doctor said there's a possibility she won't live past 8 or 9," Han Shuo's father Han Qi said.
Han Shuo, living in Tianjin, was diagnosed with Gaucher's disease in 2009, a genetic disease that makes an enzyme defective and causes a fatty substance to accumulate in cells and organs. In Han's case, it makes her anemic, enlarges her spleen and obstructs her skeletal growth.
Enzyme replacement therapy is the only method to reduce the size of her spleen and keep her blood level stable, but the medicine costs about 2 million yuan ($329,456) per year.
Gaucher's disease is categorized as a "rare disease." According to the World Health Organization, a rare disease is one that affects a small percentage of the population, ranging from 0.65 to 1 in 1,000. However, China does not have a clear definition of a rare disease. Moreover, the medicine developed to treat these diseases - often known as "orphan drugs" - are too expensive for patients, and sometimes not produced because of low profit margins.
Activists are pushing to get these orphan drugs included in national medical insurance and trying to make rare diseases more known to the public. Meanwhile, patients like Han are still faced with a dilemma.

Zhang Shuxia, an obstetrician who allegedly sold new born children to human traffickers, is on trial at the Intermediate People's Court in Weinan City in northwest China's Shaanxi Province. Zhang is charged with selling six children between November 2011 and July 2013 with one of them dying during the commission of the offence. Zhang allegedly gained tens of thousands of yuan from the trafficking. On July 16, 2013, Dong Shanshan, a local resident in Shaanxi Province's Fuping County gave birth to a baby boy at the Fuping Maternal and Child Health Care Hospital. Zhang, who was deputy director of the hospital's maternity department, told her and her husband Lai Guofeng that the child suffered from syphilis and hepatitis B transmitted from the mother and would not survive. Zhang did not let the couple see their baby but said he had already been taken away. Lai questioned the doctor's diagnosis and took his wife to another county hospital for syphilis and hepatitis B tests the following day. Two days later, the test results showed his wife was free of both diseases. On July 20, Lai contacted police who investigated and found the baby in central China's Henan Province 20 days after he was born.

A teenager has been staying in a hospital in Shenzhen, Guangdong Province for about 500 days after she received medical treatment there, though the hospital suggested she leave 14 times considering her healthy condition.Xiaomin, 16 years old, came to the Shenzhen Children's Hospital for dilated cardiomyopathy with fatal arrhythmia on July 2010, when the hospital gave medical treatment for three days and saved her life.From August 2012, the hospital began to suggest Xiaomin leave the hospital considering her healthy situation. The hospital also invited experts to carry out consultation meetings on the teenager's health several times.The hospital said the family used the patient room with three beds as their home, living there, cooking meals, bathing and resting. However, the family refused to move out.In the past 500 days, the medical fees reached another 180,000 yuan ($29,646), and the family had only paid 8,000 yuan. Xiaomin's father surnamed Ge said he could only earn about 1,000 yuan a month, and his factory was about to go bankrupt.Source: Global Times

Monday, 30 December 2013

by Michael WoodheadDeng Xiaoping was famous for chain smoking Panda brand cigarettes, but if he was still around he'd be disciplined and subject to "criticism from the masses" under new regulations that require all Party officials to set a good example in fighting the "evil influence" of tobacco.
A new directive from the Communist Party Central Committee Office and the State Council orders Party members and government officials ('ganbu') to take the lead in enforcing smoking bans in public areas, government buildings and also during government business. Officials are expected to act as model examples and to strictly uphold no smoking policies to maintain the image and reputation of the Party, the edict states.
The directive orders pubic officials to take serious note of the importance attached by the leadership to the non-smoking policies for public areas. As well as setting an example by refraining from smoking themselves, officials are also expected to actively implement and monitor programmes to enforce the smoking bans.
The no-smoking policies apply to public areas in schools, colleges, sports facilities, and cultural venues, as well as transport facilities such as airports. Officials are ordered to ensure that No Smoking signs are displayed prominently and that bans are actively enforced. Government officials are also expected to ensure that no smoking policies are implemented in government buildings - including areas such as corridors, bathrooms, stairways, reception halls and canteens.
The directive also forbids officials from smoking while on government business and from offering or supplying cigarettes to others or encouraging others to smoke while on government business.
Officials "at all levels" who fail to observe the new rules will be subject to disciplinary action and undergo criticism, the directive says. Officials can also expect to be subject to the 'supervision of the masses and public opinion", it warns.

Journalists from China's "Health News" have investigated Beijing hospitals' new appointment system introduced four months ago - and found that patients still face long and variable waits to be seen and probably always will unless a gatekeeper system is introduced.

Reporter Liu Zhenni and colleagues evaluated the new appointment system that has replaced the notorious "take a number" system that often meant patients and their families had to queue up for long periods in the early morning to get a registration number and then face additional waits until their number came up.
Under the new system patients can call a 114 number and get a registration number and 'appointment time' over the phone instead of having to queue up in person. However, when the reporters investigated the actual working of the system, they found that patients faced long delays despite arriving at the hospital at the nominated 'appointment' time. In one instance a woman who was given an appointment time of 8am at the Beijing Maternity Hospital outpatients clinic was not actually seen until 9.40am. Under the new system, patient are given an SMS reminder for the time to arrive at the hospital, but these did not reflect the time the patient would actually seen.
On speaking to hospital staff, the reporters found that waiting time varied considerably depending on the daily situation in the clinic, with factors such as patient numbers and illness type affecting waiting times for other patients.
Altogether, six hospitals have adopted the new system, and some had better performance times than others. At the Beijing Third Hospital the SMS reminder gave an 'estimated' appointment time of 1-2pm. The actual time seen was 2.30pm. At a gynecology clinic the suggested time was 2.45pm to 4pm, and the patient was actually seen at 3.15pm.

However, the appointment system is still better than the old 'take a number and wait' system. At the Dongzhimen Hospital which still uses the old system, the journalist arrived at 8am to queue for a number, and was not able to get one until 11am. He eventually was able to see a doctor at 11.30am - a total wait of 3.5 hours.
At the Meitan Hospital, Dr Zheng Shanhai told reporters it would be very difficult to achieve an accurate appointment time service under the current Chinese system of seeing patients directly in hospital regardless of grading of disease severity. Dr Zheng said some other countries had a 'gatekeeper' healthcare system in which patients were first seen in community clinics and only referred to higher grade hospitals or specialist centres if they could not be treated locally. This allowed health services to predict patient numbers and also to plan for demand and thus give accurate times for appointments. However, in the Chinese health system, doctors working in the hospital system had to be prepared to see large numbers of undifferentiated patients, said Dr Zheng. This meant that much of their time was taken up with treating minor illness, forcing patients with more serious illness to endure long waits. He likened it to catching a public bus at rush hour and having to wait in a traffic jam - under such a system it was difficult if not impossible to give an accurate estimation of the arrival time.

In the article, journalists said patients deserved to be given some idea of how long they might need to wait under the new system rather than being kept 'in the dark', but hospitals offered no information or suggestions of possible delay times. A staff member of the new 114 phone appointment system said appointment time-slots were generated by an automated system and the actual waiting time and consultation time-slot would be decided by staff in the clinics, according to 'on the ground' realities.
The journalists asked why hospitals could not provide estimated waiting times to patients, based on past experience and patient numbers. For example, if consultation times averaged 10 minutes and there were 100 patients, then it should be possible to give patients an estimated consultation timeslot according to their place in the sequence.
However, a Dr Xu at Tongren Hospital said there was no such thing as 'average' consultation time because times varied according to the patient's condition and staff availability. Hospitals were faced with an unequal and unpredictable 'supply and demand' situation, he said. It would only be possible to give an accurate appointment time if consultation times and patient numbers were strictly controlled - and this was not the case under China's current healthcare system. With rising demand for health services it would mean patients being asked to wait weeks or even months for an appointment.
A spokeswoman for the Beijing Health Department said the new system had only been operating for four months and it was still in the initial stages of implementation. Although it had aimed to give patients a consultation time-slot within half an hour of the suggested appointment time, it was not possible for hospitals to achieve such precise waiting and treatment times in the early stages, she said.Source: Health News

Eight leading state-owned hospitals in the city signed an agreement
with the Shanghai International Medical Center yesterday that will allow
doctors from the state hospitals to work at the international center.
Pudong officials said the establishment of the medical center is to
attract expatriates and wealthy Chinese to seek treatment in the city
instead of going to Hong Kong or to their home countries for treatment. The private hospital is managed by Singapore-based ParkwayHealth, the largest health group in Asia.
The medical center will start operating in March next year at the
Pudong International Medical Zone, one of the city’s two medical zones
that will host private and joint-venture hospitals offering high-end
health service.
It will be the first time that a private hospital will have medical
staff from state hospitals, thanks to the health reforms promoted by the
city to develop and promote private health facilities.

Community health service centers play a vital role for Chinese patients but they also provide services to expatriates.

Sanlitun, an area of Beijing with a large foreign population, is a prime example.

Nestled among embassies and expatriate residences,
Sanlitun health service center receives about 120,000 patients annually.
Of these, more than 400 are expatriates, including staff members of
embassies and companies and their families, said Cui Xueli, director of
the center.

"We charge them the same price that we charge Chinese residents," he said.

It costs just 3 yuan (49 US cents) to consult a doctor at the center.

According to Cui, expats go to the center mainly for
vaccinations for their children and physical checkups before they start
kindergarten. Some come for treatment of minor ailments such as colds,
fevers or inflammations, as well as dental problems.

Karoshi happens among doctors in China's large tertiary hospitals
such as Wang Qi from Armed Police General hospital. Karoshi means “death
from overwork”. The term is said to have originated in 1982 when three
Japanese doctors published a book entitled karoshi that noted many
victims of overworking and included research into their deaths. The
victims were young men who were otherwise healthy, but worked more than
60 hours a week on average and had died on the job from heart attacks
and strokes.
Recently there is an increasing outpatient workload in China's large
tertiary hospitals. The reason is that there is no general
practioner-based referral system in China and there is a huge difference
between large tertiary hospitals and community hospitals in China. At
the same time, the outpatient consultation fee is almost the same
between large tertiary hospitals and community hospitals. Thus, these
doctors from large tertiary hospitals are overwhelmed with heavy
outpatient workloads. And these factors have led to Chinese doctors
working more than 80 hours a week.
In a 2011 survey of 6,000 doctors by the Chinese Medical Doctor
Association, 78% said they wouldn’t want their children to study
medicine. And nearly 40% of medical personnel surveyed at 316 hospitals
nationwide from December 2012 to July 2013 said they plan to give up
their profession due to increased heavy workloads in hospitals. I hope
that this correspondence might reduce the heavy outpatient workloads and
avoid the karoshi of doctors in China.

Actor Jet Li says he’s being treated for an overactive thyroid, but he’s determined to fight the condition head-on.
The Chinese action star known for his kung fu skills discussed his
diagnosis during the taping of a talent show he’s judging in China.
In Tuesday’s taping, the 50-year-old Li appeared to have a fuller face and heavier frame.
He said his weight has fluctuated but he’s taking it all in stride.
Li joked about his weight and said, “I’m fat. I don’t have the time to
lose it. It’s a fact!”
He explained that exercise is not advised with the medication he’s
taking. An overactive thyroid, or hyperthyroidism, causes changes in a
person’s metabolism and heart rate, among other symptoms, but is
generally treatable with medications.
Li was diagnosed in 2010. He kept his condition under control with medication, but it came back with a vengeance recently.

Sunday, 29 December 2013

The National Health and Family Planning Commission has issued a list of "Nine Forbiddens" (“九不准”) outlining nine prohibited activities for hospitals and medical staff, in an effort to stamp out bribery, corruption and unhealthy commercial activities in the healthcare sector.

Under the rules, medical and hospital staff are:

1. Not allowed to have individual salaries linked to income from pharmaceutical products or medical tests.

2. Not allowed to receive percentages of medical billing.

3. Not allowed to charge unauthorised fees.

4. Not allowed to accept unauthorised community charitable donations or subsidies from community.

5. Not allowed to participate in sales and marketing activities or put out unauthorised medical adverts.

6. Not allowed to be involved in business cartels

7. Not allowed to be involved in unauthorised private procurement of medical and drug supplies

8. Not allowed to accept kickbacks

9. Not allowed to accept red envelopes and other inducements from patients

by Benjamin Shobert
Earlier this year I had the opportunity to connect with someone who
has a front-row seat to China’s hospital privatization. Positioned to
see deal-flow in real time, I asked the question of whether the actual
inbound investments were what either the Chinese government or
institutional investors expected after China’s recent attempts to prime
the privatization engine. The person very carefully but candidly
pointed out that thus far, actual deal flow had not been what they were
expecting.
Some of this reflects unrealistic expectations on the part of foreign capital who misread changes to China's FDI catalogue that allowed foreign ownership of hospitals
and healthcare institutions. These disappointed investors
misunderstood that China’s process of opening this sector to foreign
capital would be gradual
and would initially favor private investment and ownership by domestic
players over foreign entrants. Regardless, my contact noted that
results thus far were not what many had expected.

An infant in south China's Hainan Province died on Friday after receiving hepatitis B vaccine, local authorities said, bringing the total of such cases to 12 in the country.
Medical specialists are on their way to look into the cause of death in Lin'gao County in Hainan.
This is the third infant death linked to hepatitis B vaccines produced by the Beijing Tiantan Biological Products Co. Ltd.Source: Peoples Daily

by Laurie Burkitt
China's health regulators are rolling out a corporate blacklist for drug and medical-device companies implicated in commercial bribery, a move aimed at stamping out corruption in the country's graft-ridden health-care sector. Beginning in March, the National Health and Family Planning Commission will publish on its website a record of medical-related manufacturers, agencies and individuals charged with bribery by courts, and sued, punished or investigated for bribery, the commission said in a statement on its website Friday. The statement also said that the agency reserved the right to place any company on the list for legal and regulatory violations. Listed companies will be barred for two years from selling their products within the province in which they are implicated, the statement said. It said companies can apply as usual to sell their products in other provinces but will be at a disadvantage.Companies listed twice in a five-year period will be banned nationally for two years, the statement said.

China's vaccines are produced and regulated in
accordance with international standards, and the hepatitis B vaccination
program is vital in safeguarding children against the illness,
according to the World Health Organization.
Bernhard Schwartlander, China representative for the international
health body, made these points during an interview with China Daily on
Thursday.
"Given that the hepatitis B virus is still around, it's important for babies to get vaccinated," he said.
The WHO Beijing office met with the National Health and Family
Planning Commission on Thursday to discuss the latest developments
surrounding incidents in which 11 newborns have died after being
inoculated against hepatitis B.
According to Schwartlander, it's difficult to establish a causal link
between the vaccines and the babies' deaths since nearly all infants in
China receive the vaccine as part of a very successful vaccination
program.

Saturday, 28 December 2013

In front of a community health clinic nestled in a hutong in Dongcheng district stands a signboard that reads in Chinese: "British doctor, feet checked for free." Inside the clinic is Dr Gilbert Shia, 56, who examines the feet of people at risk of diabetes for early warning signs of the disease. Born in Hong Kong, Shia studied medicine and practiced in the UK for around 30 years before he relocated to Beijing in 2006. As a general practitioner (GP), Shia was lured to China to be a part of the government's reforms to the healthcare system. "I think the British [general practice] concept is suitable for China. If I want to promote it, I need to come to the place where policies are made," Shia said of why he chose Beijing over other cities, including his parents' hometown of Shanghai.

by Hu Jia
The number of incidents against doctors and nurses in 2013 has
increased nearly 8 percent compared to 5 years ago, according to figures
released by the Chinese Hospital Association. Over-prescription by doctors, a way to increase revenue for hospitals
and doctors themselves, is believed to be a source of increasing
complaints by the patients.
Data shows about 40 percent of hospital revenue comes from medicine
sales, with another 40 to 50 percent from diagnostic tests and
treatments.
The Chinese government has been tackling the problem in recent years.
Chen Zhu was former Chinese Health Minister, who stepped down from the post in March 2013.
He said the government aims to relieve doctors the burden of marketing medicines.
"To separate drug sales from medical treatment, we have rescinded the
policy for hospitals on medicine prices, under which hospitals were
allowed to raise prices by up to 15 percent. This would help curb
over-prescription and unnecessary check-ups."
It's hoped the reform effort will help reduce costs in the healthcare system, reducing patient complaints and violence.

Beijing is embracing primary healthcare outside traditional structures, as local governments in Chaoyang and Haidian districts introduce private hospitals and clinics to services long provided by community health centers.
"We are planning to transform a private hospital into a community health service center. It is going to open in 2014, according to the plan," said Yang Hua, deputy head of the health bureau of Chaoyang district.
Two private clinics in Haidian district are also turning themselves into primary-care providers.
"This lessens the burden on the government, as it is not able to set aside as much money and it’s hard to find a piece of land suitable to build a new community health center," said Gui Xiaohai, deputy head of the district’s health bureau. "The government should take most of the responsibility in providing primary care, but other organizations can also complement the service."

Friday, 27 December 2013

To assess injuries and make judgments on hospitals' diagnoses and
treatment plans, 1,390 medical experts in Beijing have been selected to
serve as a professional third party in medical disputes and as expert
witnesses in court, the Beijing News reported.
These experts, who
have been recommended by medical and judicial institutions, cover a
wide range of disciplines, including internal medicine, surgery,
gynecology, pediatrics, forensic medicine, nursing, etc. Their first
term will last four years.
According to an official, when a
medical dispute occurs, experts will be randomly selected by the
hospital and the patient. If any expert is found to be associated with
the hospital in question or related to the patient, they will be asked
to recuse themselves.Source: Global Times

There’s confusion over a billion yuan discrepancy in fines collected for violating the one-child policy in the southern province of
Guangdong last year .
Figures published by its finance department and the health authority
show a disparity of around 1.1 billion yuan (US$181million).
In a letter to Han Zhipeng, a political adviser of provincial capital
Guangzhou, the finance department said yesterday that 2.613 billion
yuan had been raised. However, earlier this month, Guangdong Health and
Family Planning Commission said they only levied fines of 1.456 billion
yuan.
Yesterday, the finance department said its officials had included
more cases and thus its number was bigger, according to Legal Evening
News.
The health and family planning commission said it was checking the data.

Doctors who take kickbacks from pharmaceutical companies or accept "red envelopes" from patients will face punishments ranging from reproach to dismissal.
The National Health and Family Planning Commission and the State Administration of Traditional Chinese Medicine said in a joint circular on Thursday that doctors are banned from promoting medical ads and taking commissions from the prescription of drugs.
Doctors are not allowed to accept illegal donations, nor are they allowed to purchase or use medical products, according to the circular.
The move to promote clean work styles among doctors came as part of a more comprehensive campaign against corruption launched by the Communist Party of China at the end of 2012.

The government's relaxation of its birth rule to allow more couples to have a second baby provided an instant stimulus to maternity-care and fertility centers on the Chinese mainland.
Preparations for changes that will come with the new policy — which authorities expect to be implemented early next year — are now under way.
Late last month, the Obstetrics & Gynecology Hospital affiliated with the Zhejiang University took the national lead by opening a special consultation unit designed to help newly eligible couples have a healthy second child.

Tiantan Hospital, a top-level hospital in downtown Beijing, is to be moved to the southwestern suburb of Fengtai district in 2017, officials said on Thursday.
The hospital is located inside the outer wall of Tiantan, the Temple of Heaven, a park where emperors held sacrifices during Ming and Qing dynasties.
Zhao Lei, deputy director of the Beijing Commission of Development and Reform, said moving the hospital from the Temple of Heaven will better protect the historic site.
The move will also help relieve pressure in urban Beijing and better allocate the city's medical resources, as most top-level hospitals in Beijing are concentrated downtown, he said.
"Within the radius of five kilometers from Tiantan Hospital are many hospitals, including Peking Union Medical College Hospital, Tongren Hospital, Friendship Hospital and Xuanwu Hospital," he said. "Moving Tiantan Hospital will help allocate quality medical resources to Fengtai district, and not as many people will have to swarm to hospitals downtown."
The new site of Tiantan Hospital will cover an area of 352,000 square meters, nearly four times the area of the present hospital. Construction is expected to finish by the end of 2017, for an estimated cost of 3.66 billion yuan ($603 million).Source: China Daily

Thursday, 26 December 2013

Beijing is seeking to set up medical institutions in nursing homes to improve medical services for seniors. In addition, the city's more than 9,000 hospitals and community-based health service centers will also provide services to the graying society, according to the Beijing Civil Affairs Bureau. Of the more than 400 nursing homes for the elderly, more than 30 provide medical services covered by national health insurance. Statistics show that of the 9,800 medical institutes in the city, 1,897 are community-based health service centers, and these are more equipped and have more space and beds. "We want to use the vacant beds and spare staff of the medical institutes," said Du Peng, a professor at Renmin University of China. Under current policy, hospitals are not qualified to provide seniors with beds and a pension service, which has impeded the medical institutes from fully making use of its resources.Source: City of Beijing

The hepatitis B vaccination program for newborns should stay in place despite the recent deaths of eight babies, medical experts said. But expectant mothers are worried about the quality of vaccines as authorities investigate the cause of the deaths. Jia Jidong, who leads the Liver Research Center at the Beijing Friendship Hospital, cited China's relatively high prevalence of the viral infection as a major reason for keeping the immunization program. China reported a hepatitis B prevalence of more than 7 percent.
"We would have seen a relapse of the epidemic if the program was not well implemented,” he warned.

More children are being diagnosed with autism, prompting the establishment of a new research center in Shanghai and more efforts to detect the disorder in infants. Wang Hongyi reports in Shanghai.
The "children of the stars", as autistic people are called in China, live with slow language development, an unwillingness to communicate and narrow interest ranges. Autism is a neurological disorder that affects normal brain function. It usually emerges in the first three years of life. The number of children with autism has been rising in recent years, drawing more attention to the condition, according to Du Yasong, a professor at Shanghai Mental Health Center, who is also an expert on autism. Du and his peers are still trying to determine why the numbers are up.
"There are not sufficient psychological counselors and professional medical staff for rehabilitation training for children. Much work needs to be done," Du says. Shanghai's Fudan University Autism Treatment and Clinical Research Center will establish the country's largest research network for identifying autism in children and treating it. The center will carry out a large epidemiological study among 120,000 autistic children aged between 6 and 12 by teaming up with universities and medical bodies from eight provinces. Under the three-year project, about 1,200 biological samples from autistic children will be collected to study the incidence of the disease and the factors causing it in China. Experts estimate that one in 100 children are being diagnosed with an autism, far higher than other diseases, such as cancer (1/1,500) and diabetes (1/500). In developed countries, about one in 110 children are diagnosed with autism.
"There has not yet been a large-scale epidemiologic investigation of the disease, but data from Guangzhou, Tianjin and some places show that about one in 120 children are diagnosed with the disease," says Wang Yi, vice-president of Shanghai Children's Hospital of Fudan University where the research center is located.Source: China Daily

A hospital attacker with a mental disorder was sentenced to life imprisonment after a fatal assault at a hospital in East China's Anhui province last November, said a local court Tuesday. Cai Chunfeng, 42, committed the crime of intentional homicide when he stabbed medical staff members on November 13, 2012 at the Second Affiliated Hospital of Anhui Medical University, according to the Hefei Intermediate People's Court. Cai was suspicious of the medical staff as he felt uncomfortable after receiving an enema and skin test before an operation, the court said. He killed one nurse and injured four other medical staff, according to the court. Cai was identified as having a paranoid-type mental disorder on April 16 and had diminished criminal responsibility at the time of the crime, according to the expert testimony institute of the Shanghai Mental Health Center.Source: China Daily

Post-natal care in China has taken a new twist in recent years. Modern moms are after non-conventional ways to help them recover after childbirth. Westernized, one-stop services are popular among first-time parents who are the only child. First-time mom Xun Yanna was looking for a modern answer to the Chinese tradition of Zuoyuezi. The term refers to new mothers having to stay indoors and not work for the first month after giving birth. "I don't have to worry about anything. I have everything I need to recover and to feel and look energized again. It's every woman's dream to have this five-star service," Xun says. Five-star service with a hefty price tag - some start at around 120-thousand reminbi or about 20,000 US dollars. But Xun says most modern moms like herself go against tradition and don't want to burden their parents. They prefer professional post-natal care and don't mind paying.

Tuesday, 24 December 2013

Seven children have now died in China since November following hepatitis B vaccination, raising questions of the effectiveness of the emergency response.
To date, four infants have died in south China's Guangdong Province after hepatitis B vaccinations with products made by Biokangtai,a Shenzhen drug manufacturer, the Provincial Disease Control and Prevention Center said on Monday. The four deaths in Guangdong occurred in Zhongshan, Jiangmen, Shenzhen and Meizhou, but the Zhongshan case was not related to the vaccine. The baby in that case died of pneumonia, according to the center. Autopsy results have not yet been released for the other three cases. Cause of the death can only be confirmed after autopsies which normally take 30 working days. Two babies in neighboring Hunan Province and another in the southwestern province of Sichuan died in similar circumstances, according to the National Health and Family Planning Commission. A circular on Friday ordered suspension of Biokangtai vaccinations,two weeks after the first Biokangtai link was established on Dec. 6. Babies died in Hunan on Dec. 9 and in Shenzhen on Dec. 17.

A recent string of violent disputes in Chinese hospitals has unexpectedly given rise to a shadowy new network of "medical mediators". Seeking to make a profit from disgruntled patients or patients' relatives, these false go-betweens have stoked already tense doctor-patient relations. Safety concerns are at an all-time high in hospitals around China, following a spate of bloody attacks on medical workers. And out of these violent incidents has emerged a new profession: "medical mediators". Often found floating around major hospitals and armed with basic legal knowledge, they form a shadowy and completely illicit business. "These ’medical mediators’ get their information in hospitals. They try to get in contact with patients dissatisfied with the treatment received, or with the families of patients who died in hospital." Tan Peian, director of Police Station in Zhongshan city, said.

The incidence of human brucellosis in China has been increasing
dramatically since 1999, Minerva was surprised to learn from an
epidemiological survey in BMC Infectious Diseases (2013;13:547, doi:10.1186/1471-2334-13-547).
Currently, human brucellosis is endemic in 25 of 32 provinces or
autonomous regions of China, and the paper looks at a total of 162 329
cases, reported from 2004 to 2010. Milk and cheese are not usually to
blame because lactose intolerance is common in China. Instead, it is
probably caused by the increasing density of animal herding in upland
areas and weather conditions that encourage proximity between humans and
animals. Cuddly sheep and goats are the main vectors—more independent
minded ruminants like antelope pose little threat to those who try to
farm them.Source: Minerva, BMJ

Nearly 2,600 Chinese patent medicine suppliers have to lower their selling prices within the next 50 days due to new government regulations, leading to concerns within the industry which has shown an annual output value of 510 billion yuan (US$83.9 billion), reports Guangzhou's 21st Century Business Herald.The market was abuzz recently with the news that the price adjustment regulated by the government will soon be finalized in the near future. The price decline will be more than 10%-5%, said a source, adding that products that need to drop by over 25% can slowly lower their prices over a two-year period.

Guangdong has purchased 1.45 million doses of hepatitis B vaccine for
the province after health authorities halted the use of a vaccine
suspected in the deaths of four babies.
A baby boy in Shenzhen died on Tuesday after being inoculated with
hepatitis B vaccine produced by Biokangtai, a local pharmaceutical
company.
His death was the fourth such recently after babies were inoculated
with the hepatitis B vaccine produced by the company, according to China
Food and Drug Administration.
Two babies in Hunan province and another in Sichuan province died recently after being injected with the Biokangtai vaccine.
On Friday, the administration and the National Health and Family
Planning Commission asked all hospitals to stop using the vaccine
produced by Biokangtai, and said it will investigate the cause of the
deaths and examine the company's products.

Monday, 23 December 2013

by Michael WoodheadChinese health and security authorities have launched a comprehensive hospital safety and security campaign that will require all hospitals to provide security guards, surveillance systems, mediation services and adverse event investigation and complaint resolution processes.
The campaign is in response to an increasing number of medical disputes between unhappy patients, families and hospitals that have led to fights, attacks on medical staff and riots.
An action plan, issued by the National Health and Family Planning Commission, the Ministry of Public Security
(PSB) and nine other central departments at the beginning of December, aims
at improving medical order and cracking down on crimes related to
medical workers and hospitals.
The plan requires the PSB to implement policies to investigate and crack down on criminal acts against hospital and medical staff. This will include ensuring that security staff are on duty in all hospitals at level two (county level) and above and that a security report desk is installed in all such hospitals. The plan also requires major hospitals to have video surveillance systems covering all areas, an emergency response and co-ordinating centre and reporting system to local police. Level 2 hospitals and above will be required to set up a police report desk in the hospital.
Hospital are also required to set up dispute resolution and mediation centres for the public and timely complaint and appeal processes for people with grievances.
Hospitals and public security are also to clamp down on "professional" fake protester and troublemakers hired by patients to blackmail and intimidate hospital staff.

An infant who became sick just minutes after a hepatitis B vaccination and died an hour later may be the fourth victim of vaccines produced by China’s largest hepatitis B vaccine supplier in the southern city of Shenzhen.
The deaths have triggered a nationwide suspension.
An official investigation is underway, while Biokangtai has not said where vaccines from the same batch as the Shenzhen baby received may have been sold.
Last Tuesday, the boy, born at 10:31am and apparently healthy, was given a vaccination six minutes later. At 10:39am, his face turned blue, his cries became faint and his breathing became rapid due to a lack of oxygen, Dr Yang Jinmin at the Nanwan People’s Hospital in Shenzhen, Guangdong Province, said.

by San JuanChina is able to mass-produce bird flu vaccines for people, a top Chinese scientist said on Sunday. Zhong Nanshan, an academic at the Chinese Academy of Engineering and director of the Guangzhou Institute of Respiratory Diseases, made the remark at a Guangdong provincial government news conference. "Once the H7N9 bird flu virus begins to infect many more people, is found spreading among humans, China will mass-produce the vaccine to help halt the virus' spread," he said. "China now has the ability since researchers have developed a vaccine virus strain of H7N9 avian influenza virus." The vaccine was jointly developed by several institutions, including the First Affiliated Hospital to Zhejiang University's School of Medicine, Hong Kong University, the Chinese Center for Disease Control and Prevention, National Institute for Food and Drug Control and the Chinese Academy of Medical Sciences. Shu Yuelong, director of the Chinese National Influenza Center, said it was the first domestically produced influenza vaccine virus strain. "China could share the vaccine strain with other countries through the World Health Organization to aid in H7N9 epidemic control across the world," he said.

Areas within 3 km of a farm in north China's Hebei Province, the site of an H5N2 bird flu outbreak in poultry, were confirmed to have been sealed off, according to local government.The disease killed 4,000 chickens raised at the farm in Baoding City after they showed symptoms of suspected avian flu on Dec. 17, according to the Ministry of Agriculture. The National Avian Influenza Reference Laboratory on Saturday confirmed the epidemic was caused by the H5N2 avian influenza virus after testing samples collected at the farm. Local authorities have sealed off and sterilized the infected area, where a total of 125,700 chickens have been culled and safely disposed of to prevent the disease from spreading. Bird flu, or avian influenza, is a contagious disease of animal origin caused by viruses that normally only infect birds and, less commonly, pigs. It can be fatal to humans. Earlier this week, four new human cases of H7N9 bird flu were confirmed in south China's Guangdong Province.Jiangxi Province also confirmed a human case of H10N8, a new strain of bird flu, on Wednesday.Source: CRI

Sunday, 22 December 2013

by Michael Woodhead
The China Food and Drug Administration (SFDA) has suspended the use of recombinant hepatitis B vaccine for children manufactured by Shenzhen Kangtai Biological Products (Shenzen Kangtai Shengwu Zhipin, 深圳康泰生物制品股份有限公司) after the four deaths were reported among children who received the vaccine. According to an announcement by the SFDA on 20 Dec, the four deaths were reported following vacination with batches of the company's vaccine in Hunan, Guangdong and Sichuan. The SFDA says an investigation into the cause of death is still underway and until the results of this investigation are available, the use of all batches of the vaccine is being suspended immediately, in the interests of child safety and safety of the infant vaccination program.

With people's support for breast milk running high, soaps made of breast milk have become hot sellers on Taobao, China's online store, the Nanning Evening News reported. Such soaps are generally produced by sellers who are also mothers of newborn babies. Li Zhen is one of them. It is a waste to dump surplus breast milk every day, which has a short shelf life, she said. She decided to make it into soaps and put some on Taobao for sale. With her side business, Li has jumped on a popular trend. A Taobao keyword search for "breast milk soap" yields more than 3,000 results, with prices ranging from 10 yuan ($1.60) to 58 yuan ($9.30). One store sold nearly 1,000 items in a month. Some sellers claim that the soaps, with no chemical additives, adapt to all types of skin and can be used on babies. Praise and satisfaction abounded in the customer comments. However, Xie Fangming, a dermatologist in Nanjing, said breast milk, like saliva and blood, can transmit disease if the moms are not healthy, and what's more, breast milk can easily be contaminated with bacteria and germs.Source: Beijing Daily

Health authorities in south China's Guangdong Province are on high alert against H7N9 bird flu after four new human cases were confirmed this week.From Sunday to Thursday, the province confirmed four new cases -- two in Yangjiang City, one in Dongguan and one in Shenzhen, raising the total cases in the province to six. The newly confirmed four are all in a critical condition."According to expert assessments, Guangdong faces an extremely high risk of sporadic human H7N9 infections this winter and next spring," said Zhang Yonghui, head of the provincial center for disease control and prevention.The cases may occur at any time across the province and the Zhujiang River Delta region deserves special attention," Zhang added.

Trey Lee, Hong Kong Committee for UNICEF ambassador and world-renowned cellist, shared with the media in Beijing on December 19, 2013, the details of his recent visit to remote Xunhua County in northwest China's Qinghai Province to promote UNICEF's work with the National Health and Family Planning Commission to improve maternal and child health and nutrition. Lee also talked about playing music with the migrant children from Changxindian Central Primary School in Beijing and his experiences in Qinghai, including moving stories about a female village doctor and a boy suffering from cerebral palsy.

Saturday, 21 December 2013

The Fujian Provincial Bureau of Commodity Price and Fujian Provincial
Health and Family Planning Commission said on Nov 18 that it will
adjust the costs of medical services - including emergency services –
from Dec 15.
The commission decided to raise the prices of emergency treatments
due to increasing costs - such as those involving operating ambulances -
in recent years. The fee for transport by ambulance has been increased
from 25 yuan（$4.12）to 35 yuan, and use of a stretcher will cost another
30 yuan,and psychologist will cost another 100 yuan.
The fee for a consultation with a doctor has also increased - a
consultation with any doctor up to the grade of supervisor now costs 15
yuan, and a consultation with an associate professor of medicine and
above will cost 20 yuan.
The new prices cover a wide range of treatments, including in the fields of neurosurgery, radiotherapy and physiotherapy.Source: China Daily

Medical experts of the General Hospital of the Chinese People’s Liberation Army (PLA) held a joint consultation with the medical workers on the “Peace Ark” hospital ship of the PLA Navy, which is on the mission of treating typhoon victims in the Philippines, and offered diagnosis and treatment plans for victims via a telemedicine system on December 6, 2013. The success of the joint consultation marks that the PLA has had the capability of holding ultra-long-distance medical consultations overseas and long-distance medical consultations during maritime mobile operations, an expert said. The PLA General Hospital is China’s first hospital to offer telemedicine service.

The State Council, in a document for promoting the health service industry published on October 14, called for stepping up supply and fuelling demand, and to these ends proposed a series of initiatives. The document defines the health service industry as medical services, health management and promotion, health insurance and related support services, and the pharmaceutical, medical equipment, health supplies, health food, health products and other associated industries. A key emphasis in the document is the promotion of health management and physical fitness. Normally, people in China only take care of health and visit hospital when they are ill, and there is a lack of awareness of health care and rehabilitation before and after sickness.

Shanghai has 105,000 vacant beds, yet more than a third are in care centers on the city's outskirts, according to the city's civil affairs bureau. Shen Guoming, a member of the Standing Committee of Shanghai People's Congress, said that many elderly people are unwilling to stay in these areas due to the inconvenient locations and inadequate support facilities, such as medical clinics. Shen, who is also vice-chairperson of the Shanghai Social Sciences Association, made the comments during a seminar on draft regulations for the service and management of nursing homes.

The former vice director of the Shanghai Municipal Commission of Health and Family Planning has been arrested for accepting bribes in his previous position at a local hospital, local media reported Thursday. The Shanghai Municipal Prosecutor's Office announced Wednesday that it has signed off on the arrest of the former official, Huang Fengping. Huang, 48, has been under investigation since September on suspicion that he accepted bribes related to procurement when he worked at the Huashan Hospital Affiliated to Fudan University, according to a report in the 21st Century Business Herald. Several sources familiar with the case said that the arrest was likely connected to a bribery case involving the multinational drug company GlaxoSmithKline, according to the report. They also said that several of Huang's close relatives worked for the company. Huang's name has been removed from several official websites, the report said. His last public appearance was at an event on September 13 to celebrate the 50th anniversary of a medical aid program that sends physicians overseas. Huang was a well-known neurosurgeon who earned a postdoctoral degree in neurosurgery from the University of Michigan in 2000. He went to work at Huashan Hospital after he returned to China. He became the health commission's vice director in May 2012.Source: ECNS

Friday, 20 December 2013

by Michael WoodheadOverdoses of medications such as sedatives and OTC cough remedies are the most common reasons for people needing treating for acute poisoning in Shanghai hospitals, a study has shown.
A review by forensic scientists of 230 cases of acute poisoning treated at Shanghai hospitals found that the most frequent substances leading to acute poisoning were sedative-hypnotic drugs, antipsychotic drugs, antiepileptics, cough suppressants, analgesics, antidiarrheals, and histamine receptor antagonists. Other common reasons for poisoning were ingestion of pesticides, volatile compounds, and natural toxins. Overall, medications accounted for 48% of female poisonings and 40% of male poisonings.
The researchers aid it was interesting that pesticide ingestion accounted for only 17% of all acute poisonings, which was a figure lower than for less developed parts of China. Also of interest was the very low rate of acute alcohol poisoning, which only accounted for two cases (1% of total poisonings). The researchers said this might be because alcohol poisoning was easily recognised and often self treated.
"In conclusion, the pattern of acute poisonings in Shanghai is similar to that of Japan and some European countries in that acute poisonings are mainly due to medications," the study authors wrote.
"Therefore, the relevant government departments should develop more publicity, education, and management strategies for the rational and safe use of medications. In addition, Shanghai should establish more counseling agencies and websites to address the mental problems of the public that have been brought about by rapid economic development." Source: Journal of Forensic Sciences

An inspection team for the national special operation of further enforcing medical service regulations and striking out illegal medical practices came to Hebei Province on December 12 for a two-day inspection mission. It was led by Mr. Chen Xiaohong, Vice Minister of the National Health and Family Planning Commission, and attended by concerned responsible officials of the Ministry of Public Security, China Food and Drug Administration as well as experts from Health Supervision Stations of Tianjin, Jiangxi and Jiangsu. The inspection team listened to reports on progress of the national special operation and the special examination on radiological diagnosis and radiotherapy in Hebei Province, Shijiazhuang City, Langfang City and some other districts and counties. It also conducted field inspections at 14 randomly selected units in Shijiazhuang and Langfang cities, including healthcare institutions, family planning service delivery centers, life cosmetology shops and drug stores. The team assessed the performance of these units through distributing a questionnaire to people on the spot. Problems found during the inspection activity were fed back to concerned departments. Source: NPFPC

by Hu QingyunAfter striving to get up at 4 am, and starting to queue at 6:30 am in the hospital hall, Wang Juan and her husband finally secured an appointment at 10 am with a famous obstetrician at a clinic specializing in second children in Hangzhou, Zhejiang Province.The obstetrician asked thoroughly about Wang's health, including whether, like the majority of Chinese mothers, she gave birth to her first child through a Caesarean. In a latest decision, the Communist Party of China (CPC) Central Committee allowed couples to have a second child as long as either the husband or the wife is from a one-child family. Previously, the policy required both to be single children.The easing of the family planning policy delights but also worries Wang, who unlike her husband is an only child. She is the mother of a 3-year-old girl but now yearns for a second child. "I'm 38 now. I have to consult obstetricians on whether it's OK to do so," said Wang, a white-collar employee in Hangzhou.

Thursday, 19 December 2013

by Gillian WongChinese authorities said Wednesday that a 73-year-old Chinese woman died after being infected with a bird flu strain that had sickened a human for the first time, a development that the World Health Organization called “worrisome.” China’s Center for Disease Control and Prevention confirmed the woman in the city of Nanchang had been infected by the H10N8 bird flu virus, a strain that had not previously been found in people, the Jiangxi province health department said on its website.This is the second new bird flu strain to emerge in humans this year in China. In late March, the H7N9 bird flu virus broke out, infecting 140 people and killing 45, almost all of them on the mainland. The outbreak was controlled after the country closed many of its live animal markets — scientists had assumed the virus was infecting people through exposure to live birds.Timothy O’Leary, spokesman for the World Health Organization’s regional office in Manila, said WHO officials were working closely with Chinese authorities to better understand the new virus. He said though its source remains unknown, birds are known to carry it and it would not be surprising if another human case was detected.

Many illegal clinics are flourishing in Daxing district, the suburban area nearest Beijing's downtown core. Because of convenient transportation and cheaper rents, the region has become the top choice of low-income migrants, the Beijing Daily reported. As more people settle there, the need for medical services has increased. Most of the hospitals and clinics that have sprung up to meet the demand are unlicensed, but residents are willing to overlook their illegal status because the services are inexpensive, the doctors make house calls, and no registration fee is required. Between 2007 and 2013, the Daxing Procuratorate has tried 31 cases of practicing medicine without a license, a record-breaking number.Source: Global Times

Chillies for a headache and a bull's urine for jaundice: These are the latest deciphered messages of how Chinese people two millennia ago cured themselves, and their horses.
The 920 medical bamboo slips, together with other historical relics of the Western Han Dynasty (202 BC- 9 AD), were found in a subway construction site in Chengdu, capital city of southwest China's Sichuan Province.
A total of 184 bamboo slips are said to be the "guidebook" for horse vets. The remaining 736 can be categorized into nine separate medical texts covering various domains.
According to Xie Tao, a research fellow with Chengdu's archaeology institute, the books could be lost medical classics written by the successors of Bian Que, a medical pioneer from the 5th century B.C.
Two characters in one of the books have the same pronunciation as Bian Que, though in different written forms, said Wu Jiabi, of a bamboo script research institute in neighboring Hubei Province.
Bian Que was said to have invented the technique of taking the pulse and narcosis. He perhaps performed the world's earliest organ transplant, as recorded in Lie Zi, an important classic of Taoism.
The bamboo slips did not contain any sorcery, believed to indicate the separation of medicine and witchcraft and the budding of medical science.Source: China Daily

Chinese pulmonologist Zhong Nanshan said on Saturday that PM2.5 not only increases the risk of lung cancer, but also can cause overall damage to the human heart and lung, the Guangzhou-based New Express reported. Zhong said research on the relationship between PM2.5 and lung cancer has been done for dozens of years in Western countries, and results show lung cancer deaths would increase by 17 to 25 percent for each 10μg per cubic meter rise in the concentration of PM2.5. A research report issued by the World Health Organization on Nov 17 said smog may cause bladder cancer as well, and current studies in China have found that particulate matters can enter the bloodstream and cause damage to the heart and lung, Zhong added. However, China hasn't conducted any long-term research on smog's influence on human health. PM2.5 concentration in China is five times, or even 10 times, higher than in foreign countries' studies, Zhong said. "I would like to lead the research."

by Peter EdwardsTo the average newspaper reader, the story out of China seemed like science fiction or even a hoax: a man’s severed hand was transferred to his leg for a month to keep it alive, and then sewn back onto his arm.To pioneering University of Toronto plastic surgery professor, Dr. Dimitri Anastakis, it was certainly impressive but not shocking.“We’ve done comparable things at the University of Toronto,” Anastakis said in an interview.
“I’m impressed with the creativity,” Anastakis said. “I’m impressed with the drive to save the person’s hand and restore function. . . It’s particularly cool. . . In China, they do phenomenally creative work.”The Xiaoxiang Morning Herald reported that 25-year-old Xiao Wei lost his right hand in an industrial accident in the central province of Hunan

by Andrew Jack and Patty Waldmeir
Unshaven and dressed in a blue and grey striped T-shirt, Liang Hong looked nondescript on screen. But his words, broadcast on Chinese television last July, were explosive. He told two policemen how, as a vice-president of GSK, he had channelled concealed payments via a local travel agency. On the same day, Gao Feng, a leading fraud investigator, held a highly unusual briefing for foreign journalists at which he likened the British-based pharmaceutical company to the “big boss” in a “criminal partnership”, paying up to Rmb3bn ($500m) to officials and doctors. He claimed it used 700 travel agencies, some in turn offering money and “sex bribery” to GSK executives to win their favour.

Wednesday, 18 December 2013

Shanghai has set up a key mental health research laboratory to intensify efforts to diagnose and treat severe mental illnesses, which affect nearly 1 percent of China's population.
"Over the past 20 years, there has been little progress in the field," Xu Yifeng, president of the Shanghai Mental Health Center, said in a recent interview.
"The question of how to combine basic science and clinical research has not been solved."
The new lab, opened in November, will focus on solving a bottleneck in the study of severe mental illnesses through a combination of multiple disciplines, such as molecular and cell biology, brain imaging and bioinformatics, a method for processing biological data using computer science and mathematics.

Shanghai Health and Family Planning Commission said yesterday it is encouraging health professionals at state-owned hospitals to work at private medical facilities, while also encouraging foreign investors to set up fully owned units at the Shanghai free trade zone. Currently, only those from Hong Kong, Taiwan and Macau can set up solely invested medical facilities in certain provinces and cities on the mainland, while foreign investors need local partners to set up joint venture facilities. But that may change as Shanghai authorities are encouraging foreign enterprises to set up hospitals and clinics in the zone with their own investments. Xu Jianguang, the commission head, said it only needs 40 days for a foreign firm to set up a health unit in the zone.

Relaxation of China's one-child policy both delights and worries Wang Jingjing, who gave birth to a boy three years ago by Caesarean section and now yearns for a second child. "I have consulted many obstetricians, but still can't make the decision on being pregnant again," said Wang, a white-collar employee in Hefei, capital city of east China's Anhui Province. Like Wang, many Chinese mothers pleased by the loosening of the birth policy are now worried about the possibility that the Caesarean section they had might jeopardize a second child. Last month, the government proposed allowing urban couples to have two children -- as long as either the husband or the wife is an only child. Previously, the policy required both of them to be a single child.

Some 5.88 million residents in Shanghai have joined the family doctor
system, accounting for 32 percent of the city's population, according
to the director of Shanghai Municipal Commission of Health and Family
Planning, eastday.com reported Sunday.
Shanghai currently has more than 3,200 family doctors. The pilot family doctor program was launched in 2011.
The program aims to treat less urgent illnesses at community level, and relieve pressure on top-tier hospitals. The commission added that each resident in the city might have access to a family doctor by 2020.Source: ECNS

When medical schools no longer attract the brightest minds, when doctors become the target of attacks, and when weapons of self-defence become necessary in hospitals, something is clearly amiss.
Worryingly, the symptoms are spreading on the mainland, so much so that they are further jeopardising the already ailing health care system in the world's most populous nation. The need for major surgery is evident.

Tuesday, 17 December 2013

by Michael WoodheadAlthough metformin is the first line treatment for type 2 diabetes, the α-glucosidase inhibitor acarbose has been shown in a major Chinese trial be be a worthy alternative in patients with a marked postprandial glucose changes.
In The Lancet Diabetes & Endocrinology, Professor Yang Wenying and colleagues from the Department of Endocrinology, China-Japan Friendship Hospital, Beijing, report the findings of a randomised controlled trial that compared the α-glucosidase inhibitor acarbose with metformin as initial treatment for type 2 diabetes.
In a study known as the MARCH (Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) trial they recruited 788 adult Chinese patients who were newly diagnosed with type 2 diabetes. Patients were randomly assigned to receive metformin (up to 1500 mg sustained release preparation) or acarbose (titrated gradually up to a maximum of 100 mg three times a day). At the end of the 48-week study period, acarbose was found to be as effective as metformin in terms of its HbA1c-lowering effect , and both treatment regimens achieved weight loss, although patients in the acarbose group lost slightly more weight (−0·63 kg). Patients assigned to the acarbose group also had a more favourable lipid profile, with improved HDL and lower triglycerides at 48 weeks. As expected, treatment with acarbose was associated with less postprandial hyperinsulinaemia than with metformin.
An accompanying editorial says alpha-glucosidase inhibitors remain most popular in Asian countries such as China, where rice forms a major component of the diet and the dietary contribution of carbohydrate is high.
“The results of this large study indicate that the efficacy of acarbose could be related to the carbohydrate content in the patients' diet, which suggests that acarbose would be more effective in populations with a high carbohydrate intake,” it said. Source: The Lancet Diabetes & Endocrinology

Low salaries, workplace pressures and occasional violence by patients against doctors are dissuading an increasing number of top high school students from pursuing careers in medicine. The situation has become so acute that some medical students are abandoning their studies for other majors or even choosing other careers after graduation. According to the Chinese Medical Doctors Association, there were 17,243 cases of violent attacks against health care workers in China in 2010. The Chinese Hospital Association said there were an average of 27 attacks on medical staff in each hospital in 2012. On October 25, an angry patient stabbed a senior doctor to death at a hospital in Zhejiang Province. Patient violence often results from frustration and anger with the health care system. A survey by the association found 78 percent of Chinese doctors don’t want their children to follow in their footsteps.

Health authorities of Hunan, central China, are investigating three cases of adverse reactions to hepatitis B vaccination, including two deaths.
A one-month-old boy died on December 6 in Hengshan County, two days after being vaccinated. Another eight months old died in Changning City on December 9, one day after vaccination for both hepatitis B and flu. A third newborn in Hanshou County showed a severe adverse reaction after being vaccinated on November 25, the Hunan Provincial Center for Disease Control and Prevention said Monday.

Just a month ago, Xia Qiang, a surgeon from Shanghai Renji Hospital, and his team made history by completing the first two transplant operations using organs donated by residents in the city.Such operations are taking place with increasing frequency across China, showing a determination to move from sourcing organs from executed prisoners to acquiring organs from citizens willing to donate.China is the top country in the world in terms of carrying out organ transplants as well as for having the most patients waiting for transplants. According to official figures from Chinese health authorities, more than 1.3 million patients wait for organ transplants each year while only 10,000 are lucky enough to get one. The rest try their luck in the underground black market.Prior to 2010, the majority of Chinese organ transplants came from executed prisoners, prompting criticism from the international community.

Fengcheng Yuandu Clinic, a hospital in Yuandu township, Jiangxi province, is responsible for the health of 50,000 local residents and has gradually become a medical center serving surrounding areas in recent years.
Hospital Director Zou Huihua said he puts great effort into improving the quality of medical teams and the service of the hospital.
Ensuring the healthcare in townships like Yuandu and rural China is very important, Dr Zou said.
The Chinese government approved a series of proposals to improve the healthcare system in townships and villages during the most recent session of the CPC Central Committee congress held in November.
As an experienced doctor at the grassroots level for nearly 20 years, Zou believes what he has been doing is indeed meaningful.
"There are a lot of doctors in big cities," Zou said. "But in townships and villages they need people like me."

In 2011, China transplanted
more organs than any other country except the United States. The source
of those donated organs is a worldwide concern. A few hundred
of the 10 000–12 000 organs came from intensive care units
as donations after cardiac death; brain death is not legally recognised
in China. An unknown number were sourced from living donors. The use of
executed prisoners’ organs has been acknowledged by government
officials, but despite efforts to change this, executed prisoners still
comprise most organ donors. The Falun Gong movement and its supporters claim that they are targeted as organ donors through execution.

Despite at least 100 000 Chinese citizens needing
transplants each year, internet advertisements for foreigners to
purchase organ transplants continue, although banned by Chinese law in
2007.
Sales of organs have continued, albeit at a reduced volume, reportedly
with up to $1 million paid for “priority for liver transplant
allocation”.

What is the reality and what should transplant and medical
professionals and the Australian community do?

Trends in HIV treatment in Shanghai: antiretroviral treatment has been increasingly used in patients with higher CD4 counts since 2006 and stavudine regimens are prescribed less frequently.
“Strategies to facilitate early access to antiretroviral treatment and further reduction in stavudine use are needed,” says Dr Lu Hongzhou and co-researchers from the Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China . Source: International Journal of STD and AIDS

Why do Chinese consumers opt for more expensive branded drugs over cheaper generics? Because they don’t trust cheaper drugs and the stores that provide them, according to a survey of 250 consumers by Dr Zhou Zhiliang of the China Pharmaceutical University, Nanjing. Source: Health Marketing Quarterly

Pertussis is still circulating in China, and the reported incidence might be underestimated, according to a study of children in a regional town in Hebei by Dr Zhao Shuzhun of the Department of Respiratory Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Beijing.Source: Epidemiology and Infection

How does the composition of surgical teams in the operating room affect surgical team performance and procedure times? Interesting results from Dr He Wenjing and co-researchers at the Department of Minimally Invasive Surgery, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong.Source: Surgical Endoscopy

Nontyphoidal Salmonella pathogens are a common cause of serious gastrointestinal infections in children, and there is a worrying level of antibiotic resistance, according to a study by Dr Wang Xiaohong and co-researchers at the Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai. “Ongoing surveillance for Nontyphoidal Salmonella infection and antibiotic resistance is needed to control this pathogen in Shanghai,” they conclude.Source: Foodborne Pathogens and Diseases

Human enterovirus 71 (EV71) was the major pathogen of Hand, Foot and Mouth Disease in Guangdong during the 2010 epidemic, a study from the Guangdong Provincial Centrr for Disease Control and Prevention, Guangzhou has found. The infection occurs mostly in children less than 3 years of age, who should have first priority to receive an EV71 vaccine, the researchers say.Source: PLOS One

Syphilis is still an important cause of pregnancy loss and infant disability in China, particularly among women who do not receive prenatal care or have late or inadequate treatment, a study from Shenzhen has shown. Researchers from the School of Public Health, Central South University, Hunan, screened 279,334 pregnant women and identified 838 (0.3%) women infected with syphilis. About 8% of infants born to syphilitic mothers were diagnosed as having congenital syphilis and 25% of women had adverse pregnancy outcomes.
“These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment,” the study authors said.Source: Sexually Transmitted Diseases

Beijing researchers have clarified the underlying heart disease and microbiological pathogens associated with infective endocarditis in Chinese patients.
In a study of 115 adult patients admitted with infective endocarditis to Peking University First Hospital, Dr Li Xiangyan and co-researchers found that the most common underlying heart diseases were congenital heart disease (24%) followed by degenerative valvular disease (17.4%).
Aortic (44%) and mitral (43.5%) valves were most frequently affected.

China's police on Saturday announced that over 1,300 people have been arrested as suspects involved in illegal drug sales online amid a special crackdown. Chinese police launched a special combat, including three intensive raids, against illegal online drug sales and sales of fake drugs since June this year and to date police forces in 29 provincial-level regions have closed 140 unlicensed websites and online drug stores, according to a statement by the Ministry of Public Security. Moreover, police has seized more than nine tonnes of raw materials for fake drug manufacture, the statement said. The statement said illegal online sellers often use deceptive advertisements to lure buyers and most of the drugs were found to be made of starch or spoiled materials. Some drugs contained illegal, psychedelic or poisonous ingredients that may harm user's health, it said.Source: Xinhua

The lucrative black market for babies in China is growing by the day. Liu and her husband Duan, both aged 40, have been working in Dongguan City in Guangdong Province. In October, Liu came back to her hometown in Tongcheng County to prepare for her baby’s birth. On the night of Nov. 1, she went into labor and her family took her to Tongcheng People’s Hospital, where she was directly checked into the delivery room. She gave birth to a baby boy the following morning by caesarean section.

Sunday, 15 December 2013

by Li Binli
China’s aging population has increased to approximately 200 million and is larger than that of the whole of Europe. So the number of older patients is increasing with time. Meanwhile, thousands of hospitals have established an ICU in the last 20 years, and this has brought about a grim problem. For example, more and more older patients, who would have died within a short period of time in the past, may now achieve long-term survival. For these patients, intensive care just means extended life or postponed death. These hopeless patients occupy an already scarce medical resource, and this makes it impossible for some critically ill patients to receive effective treatment. Owing to the influence of Chinese traditional ethics and the lack of corresponding laws and regulations, overtreatment of hopeless patients frequently takes place. In fact, it is a futile treatment. Chinese society needs to develop approaches to address the appropriate delivery of critical care to the increasing population of older people, especially those with chronic life-limiting disease.

Mo Qiulian ties up small bundles of firewood as she murmurs to herself: “Why haven’t I died?”
The 67-year-old villager has thought of killing herself many times
since she had a stroke in March, followed by four months of lying in bed
unable to move before regaining some mobility in her upper body.
Mo is one of many elderly residents in Kongtong Village of Hunan Province who say they will commit suicide one day.
They look forward in fear to a lack of medical care to deal with
diseases as they get older. They are uncertain what the future holds,
feeling insecure because their children left for the city and may never
return, the Sanxiang City Express said yesterday.

China's private health companies are seeking more opportunities to introduce high-quality medical services from overseas to the domestic market. A flagship healthcare center operated by Ikang Guobin Healthcare Group opened at the LG Twin Towers in Beijing yesterday. It will target customers with higher incomes, with better private medical services. The center has invited Tom Fox, vice-president of Harvard Medical School, to be its director. Physicians from the school will visit the center for regular treatment and consultation sessions.

Japanese medical authorities are expressing concern
over prenatal testing for chromosomal abnormalities now offered by a
Chinese company because it does not require clients to undergo
counseling, which could lead to unnecessary abortions.
The Chinese company, BGI, recently entered the market and is
offering the service in Japan at less than half the cost charged at
facilities sanctioned by the Japanese Association of Medical Sciences
(JAMS).
Fumiki Hirahara, a doctor of obstetrics at Yokohama City
University who is well-versed in prenatal care, expressed concern over
BGI’s program, citing the lack of counseling.
“If testing becomes common among expectant mothers, and they
lack the mechanism to properly assess the accuracy of the results, it
could prove detrimental for them (and their babies),” he said.
Hirahara said Japanese medical personnel started doing
prenatal testing in April as part of clinical research, with an eye on
evaluating the benefits of genetic counseling.

Saturday, 14 December 2013

China is planning a national regulation banning smoking in public indoor areas, and it is expected to be enacted next year, the Beijing News said Thursday, citing an official. Yang Jie, deputy director of Tobacco Control Office for the Chinese Center for Disease Control and Prevention, made the remarks at a news briefing on the Chinese version of the Tobacco Atlas (fourth edition), a comprehensive volume of research on tobacco and smokers. Yang said the regulation, following the Framework Convention on Tobacco Control, will ban smoking in all public places, including public vehicles, indoor workplaces, Internet bars and restaurants. Specific penalties for violations will be included in the regulation, he added. More than 10 Chinese cities currently have smoking control rules, all of which ban smoking in public indoor areas, but implementation of the law is unsatisfactory, mostly because there is a lack of enforcement and awareness about the law. The Tobacco Atlas, published by the American Cancer Society, says more than half of Chinese males smoke, and 12 percent of deaths in Chinese males can be attributed to tobacco. Every year, 600,000 people die from exposure to secondhand smoke in China, most of them women and children, it said.Source: Beijing News

by Amy Li
The family of a 35-year-old woman who died giving birth last month is accusing a Jiangxi hospital of malpractice, and is considering launching a third-party investigation into the matter, Chinese media reported.But what infuriated many Chinese bloggers more than the dispute over patient Li Xiaoyang’s death was what many called a “cold-blooded” comment from the doctor who operated on Li, Guangren hospital president Zhang Ning.In an interview with Southern Metropolis Daily this week in Wuren county, Zhang allegedly said, “A hospital is the place where people die.”

Small-sized hospitals are plagued by touts who buy medicines at very low prices from patients with medical insurance, sell them and pocket the difference, the Beijing Evening News reported.Some dealers even rent patients' medical insurance card to directly purchase medicines from the hospital. Websites are often set up as the final step in this medicine-recycling business. Most of the medicines are either sold online or to smaller unlicensed drugstores. Such illegal websites were banned in 2011.Source: Global Times

Medical institutions are not allowed to refuse HIV/AIDS patients for any reason, central government authorities said on Friday. Local health authorities will strengthen supervision of practices and deal with violations, said a National Health and Family Planning Commission statement. A recent circular jointly issued by the commission and five other central government departments demanded more efforts to protect the rights of those with HIV so they receive proper treatment, according to the statement. Hospitals should provide treatment and if a patient is diagnosed with the HIV/AIDS infection, the institution that first received them should be responsible for treating them, the statement quoted the circular as saying.

Friday, 13 December 2013

Medical researchers have uncovered an alarming link between HPV virus and the quadrupling of a string of deadly cancers in China.
The deadly Human Papilloma Virus increases the risk of oesophageal squamous cell carcinoma (OSCC) in China by almost four- fold, according to research led by University of New South Wales (UNSW) academics.
In addition to causing cervical, anal and genital cancers, HPV has more recently been found to cause head and neck cancers. OSCC is a cancer where a possible link with HPV has been postulated in the past, but not resolved.
"The problem with OSCC is that there is no way to screen for it, so it is usually diagnosed quite late and has a very high mortality," said the first author of the paper, Surabhi Liyanage, a PhD candidate with UNSW Medicine.

A new model that provides both healthcare and elderly care for senior
citizens was proposed recently in Beijing. More than 9,000 healthcare
institutions are expected to get licenses to offer beds to the elderly.
Beijing has 608 hospitals and 1,897 community health service centers.
Even if only half of them each provide 20 beds, it will result in an
increase of 25,000 beds.
More than 80,000 beds are available for the elderly in the city, but
almost 30 percent of beds are unoccupied. Most people prefer locations
that offer good medical services and avoid those with bad reputations.
Thus, some places are almost full while others have 50 percent of their
beds unoccupied.

China will blacklist producers of illicit food, drugs, medical appliances and cosmetics, according to a draft regulation published on Thursday.
Information on producers who "have seriously violated laws and regulations concerning food, drugs, medical appliances and cosmetics management and received administrative penalties" will be made public through government websites, says the draft regulation, which was issued by the China Food and Drug Administration.

Guangzhou city bureau of health is seeking a legal remedy under a plan that asks its medical workers to study the law amid rising doctor-patient disputes, Guangzhou-based Nanfang Daily reported. According to the plan, legal science will be an important part of educating medical workers in the city. The moves hopes to boost awareness among staff of their legal rights as well as allowing them to settle disputes. On Monday, more than 100 people smashed Guangzhou Elizabeth Women's Hospital, resulting in injures to six members of the medical staff, after an expectant mother suffered complications and lost her child. In October, two doctors and a nurse from the No 2 Hospital affiliated to Guangzhou University of Medical Science were seriously injured after they were attacked by family members of an elderly woman who died in the hospital. Guangzhou is the first city to ask medical staff to study the law.Source: China Daily

Emissions from coal plants in China were responsible for a quarter of a million premature deaths in 2011 and are damaging the health of hundreds of thousands of Chinese children, according to a new study.The study by a US air pollution expert, commissioned by Greenpeace, comes as many areas in northern and eastern China have been experiencing hazardous levels of air pollution in recent weeks.
In some eastern cities including Shanghai, levels were off the index that tracks dangerous pollution, with schools closing and flights being cancelled or diverted. Sales of air purifiers and face masks have soared with many retailers selling out of stock as residents try to protect themselves from the poisonous smog. In Jiangsu and Zhejiang provinces visibility was reduced to less than 50 metres earlier this week and in the city of Nanjing a red alert for pollution was maintained for five consecutive days.

Thursday, 12 December 2013

In a new study published today, researchers have discovered that the Chinese bird flu strain, A(H7N9), has a mutation immunizing it to common anti-viral drugs. While this doesn’t necessarily herald cause for concern of a pandemic, the researchers recommend using anti-viral drugs with caution. Many seasonal influenza strains become less transmissible after they become resistant to drugs such as Roche’s Tamiflu. But the scientists found that the avian influenza strain, doesn’t work in the same way. It maintains its ability to be transmitted, even after it develops an immunity to drugs. The researchers urge doctors to make wise choices when handing out anti-viral medications for H7N9 cases — they should avoid using common drugs like Tamiflu, which could help build resistance in the virus, the researchers suggested.

Blog post by Dr Zachary Sholem Berger: "I sat in on rounds at Peking Union Medical College Hospital, my host and one of the top-ranked hospitals in China. The General Internal Medicine Division is renowned for its ability to treat the hardest cases and consistent high reputation, which becomes a self-fulfilling prophecy in certain respects (sound familiar?).
The similarities are not all that interesting: the team sits round a table and talks about the new patients, then walks through the wards seeing the old patients. Questions are asked to put medical students on the spot (in American English we have a word for that). The differences, however, are somewhat instructive.